Collaboration between EMS and primary care physicians could reduce unnecessary emergency transport for fallen seniors

Press Release:

A protocol that couples paramedic assessment with primary care physician consultation and timely follow up significantly reduced unnecessary ambulance transport for fallen elderly residents of assisted living facilities. The findings of a prospective cohort study are published in Annals of Internal Medicine.

Unintentional falls are the leading cause of nonfatal injury for adults aged 65 years or older who are treated in emergency departments in the United States. Residents of assisted living facilities who fall may not be seriously hurt, but policy still dictates that they be transported to the emergency department. These policies burden the health care system and place patients at risk for harms, such as unnecessary tests or exposure to infection. Therefore, limiting unnecessary transport is desirable.

Researchers from Wake County Emergency Medical Services sought to determine whether unnecessary transport to the emergency department could safely be avoided for patients who experienced a ground-level fall in an assisted living facility. Wake County Emergency Medical Services collaborated with Doctors Making Housecalls, a group of  specializing in home care for older adults, to develop a protocol for specially trained paramedics to identify a subset of patients who would not be transported to the emergency department but instead would be scheduled for a visit with a  provider within 18 hours of the call for .

The study involved a convenience sample of 953 residents, 359 of whom had 840 ground-level falls over 43 months. The protocol recommended nontransport after 553 falls, which marked a substantial decrease (62.9 percent) in transports. The researchers concluded that 98 to 99 percent of nontransported patients received safe, appropriate care. If implemented on a widespread basis, this approach could potentially avoid large numbers of unnecessary ambulance transports to the  for simple falls.

 Explore further: Hospital or home? Guidelines to assess older people who have fallen

More information: Annals of Internal Medicine (2017). annals.org/aim/article/doi/10.7326/M17-0969

Patient Navigation for Patients Frequently Visiting the Emergency Department

From Urgent Matters:

A new study from the University of Tennessee[ii] aimed to help keep frequent ED users from needing the ED through the use of a patient navigator program. The research team created a patient navigator program that worked within the ED to help patients review diagnoses and prescriptions, arrange follow-up appointments and transportation, and identify relevant community resources. The navigator would meet with the patient to perform these tasks during the initial visit, any following ED visit, and by telephone within 2 weeks and 12 months of the initial visit.

Superusers were defined as any patient presenting to the Erlanger Baroness ED for their fifth visit or more within a 1-year period. Once a patient was properly consented for participation in the pilot, they were assigned to the control arm or the experimental arm. The control group also received a call from a research assistant at the 2 week and 12-month time post the initial visit to the ED.

Maternity Wards Are Disappearing From Rural America

From Governing:

Maternal health in rural America is made more complicated by the fact that rural areas routinely rank higher than urban areas in rates of noncommunicable diseases and preventable deaths. Birth outcomes are poorer, too. And with fewer and fewer ob-gyns available, there will likely be more high-risk pregnancies, unhealthy births and resulting long-term health issues. “What happens during pregnancy sets the tone 20 or 30 years down the road,” says Lisette Jacobson, an assistant professor of preventive medicine and public health at the University of Kansas.

Meanwhile, costs and maternity ward closures are likely to continue to mount. Anderson says that by offering obstetric services, his hospital is operating at a six-figure annual loss, even after receiving funding through a public-private partnership to expand its maternity offerings. Women are coming in from two hours away to give birth, and the hospital is quickly running out of birthing space, he says.

Doctors aboard international flight perform CPR for hours, save woman’s life​

From KCRA:

WFTS reports Debbie Taylor, of Tampa, was on a Delta Airlines flight 40,000 feet above the Pacific Ocean when something went wrong.

“I remember telling the woman next to me…’I don’t feel well. I need to get home,'” she recalled.

Taylor became unresponsive and three doctors, who just happened to be on board, jumped into action to try and save her life.

“They gave me CPR for about five hours,” Taylor said.

Eventually, pilots were able to put the plane down in Alaska for an emergency landing. Taylor was rushed to the hospital.

Doctors placed her on life support and her daughter Cheryl Cowans rushed to her mother’s side.

“I was worried she was gonna be brain dead,” Cowans said.

But Taylor improved and came out of her coma, against the odds.

NewYork-Presbyterian and Walgreens Collaborate To Bring World-Class Care Through Telemedicine

Press Release:

NewYork-Presbyterian and Walgreens are collaborating to bring convenient access to NewYork-Presbyterian’s world-class care through new telemedicine services, now available through Walgreens digital properties and at self-service kiosks at select Duane Reade drugstores in New York.  NewYork-Presbyterian, New York’s No. 1 hospital, is offering the telemedicine services as part of its NYP OnDemand suite of digital health services.

“We are delighted to work with Walgreens to bring NewYork-Presbyterian’s world-class care right to your neighborhood drugstore with this exciting new platform,” said Dr. Steven J. Corwin, president and CEO of NewYork-Presbyterian. “Patients can expect to receive focused, one-on-one care from leading physicians, where and when they need it. We believe telemedicine has a critical role to play in expanding access to high-quality care, and we are proud to be at the forefront of digital healthcare delivery.”

The first NewYork-Presbyterian NYP OnDemand kiosk is currently available at the Duane Reade location at 40 Wall Street in Manhattan, with additional locations expected to open in 2018. These kiosks, located in private, secure rooms inside the stores, offer instant examination, diagnosis and treatment of non-life threatening illnesses and injuries through NYP OnDemand Urgent Care. With the touch of a button, patients can reach board-certified Weill Cornell Medicine emergency medicine physicians, who provide exams through a high-definition video-conference connection. At the end of the examination, if the physician writes a prescription, it can be instantly sent to the patient’s preferred pharmacy. Pediatric emergency medicine physicians will also be available to provide care during more limited hours. Physicians from ColumbiaDoctors are expected to participate in early 2018.

“These kiosks provide real-time care for our patients, enabling them to consult Weill Cornell Medicine physicians privately through the convenience of their local drugstores,” said Dr. Augustine M.K. Choi, the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine. “We are proud to work with NewYork-Presbyterian and Walgreens to extend the reach of our doctors beyond their offices, making healthcare accessible to patients across the city.”

“This technology gives us another way to bring Columbia physicians to the neighborhoods where our patients live and work,” said Dr. Lee Goldman, dean of the Faculties of Health Sciences and Medicine and chief executive of Columbia University Irving Medical Center. “Improving access to doctors is a fundamental way to improve our patients’ health and well-being.”

In addition to the in-store kiosks, Walgreens customers in the New York area using the Walgreens website can access NYP OnDemand Urgent Care to video chat with board-certified emergency medicine doctors.

“We believe that telemedicine can play a critical role in connecting patients with providers,” said Greg Orr, divisional vice president of digital health for Walgreens. “We can now help to bring awareness of services that are offered locally by trusted providers such as NewYork-Presbyterian. We are pleased that NewYork-Presbyterian will be the first local healthcare provider to collaborate with us on our evolving telehealth and digital strategy.”

The kiosk experience is further enhanced with medical devices to provide key information to the physician during the virtual visit. These include a forehead thermometer that measures temperature with a gentle swipe of the forehead, a blood pressure cuff to measure blood pressure and a pulse oximeter that measures the amount of oxygen in the body. A dermascope, which allows the provider to see a high-resolution view of skin conditions, is also available.

“We’ve had much success over the years working with NewYork-Presbyterian at our on-site Walgreens pharmacy,” said Dr. Pat Carroll, chief medical officer for Walgreens Healthcare Clinics. “We value this innovative collaboration and look forward to finding new and different ways to work together to enhance patient care.”

Visit times are expected to take about 10 to 20 minutes but will vary depending on the patient’s individual needs. The urgent care service is designed to care for non-life threatening conditions, illnesses and injuries such as: sore throat, allergies, rash, pink eye, abdominal pain, asthma, cold or the flu, dizziness, fever, and sprains. For a full list of conditions, please refer to: www.nyp.org/ondemand/urgent-care.

The kiosk hours at 40 Wall Street are 8 a.m. to 9 p.m. Monday through Friday and 9 a.m. to 6 p.m. Saturday and Sunday. Pediatric emergency medicine physicians can be reached from 6 p.m. to 9 p.m. on weekdays.

The video visits are part of NewYork-Presbyterian’s award-winning digital health suite of services, NYP OnDemand. Launched in 2016, NYP OnDemand, in collaboration with Weill Cornell Medicine and ColumbiaDoctors, is designed to improve access to NewYork-Presbyterian’s world-class care, allowing patients to easily communicate with physicians from a mobile phone, tablet or computer – and now through these kiosks at select Duane Reade locations. To learn more, visit: http://www.nyp.org/ondemand/urgent-care-kiosk

NewYork-Presbyterian

NewYork-Presbyterian is one of the nation’s most comprehensive, integrated academic healthcare delivery systems, whose organizations are dedicated to providing the highest quality, most compassionate care and service to patients in the New York metropolitan area, nationally, and throughout the globe. In collaboration with two renowned medical schools, Weill Cornell Medicine and Columbia University Irving Medical Center, NewYork-Presbyterian is consistently recognized as a leader in medical education, groundbreaking research and innovative, patient-centered clinical care.

NewYork-Presbyterian has four major divisions:

  • NewYork-Presbyterian Hospital is ranked #1 in the New York metropolitan area by U.S. News and World Report and repeatedly named to the Honor Roll of “America’s Best Hospitals.”
  • NewYork-Presbyterian Regional Hospital Network comprises hospitals and other facilities in the New York metropolitan region.
  • NewYork-Presbyterian Physician Services, which connects medical experts with patients in their communities.
  • NewYork-Presbyterian Community and Population Health, encompassing ambulatory care network sites and community healthcare initiatives, including NewYork Quality Care, the Accountable Care Organization jointly established by NewYork-Presbyterian Hospital, Weill Cornell Medicine and Columbia.

For more information, visit www.nyp.org and find us on Facebook, Twitter and YouTube.

 Walgreens

Walgreens (walgreens.com), a provider of trusted care in communities since 1901, is included in the Retail Pharmacy USA Division of Walgreens Boots Alliance, Inc. (NASDAQ: WBA), the first global pharmacy-led, health and wellbeing enterprise. Approximately 8 million customers interact with Walgreens in stores and online each day, using the most convenient, multichannel access to consumer goods and services and trusted, cost-effective pharmacy, health and wellness services and advice. Walgreens operates 8,100 drugstores with a presence in all 50 states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands, along with its omnichannel business, Walgreens.com. Approximately 400 Walgreens stores offer Healthcare Clinic or other provider retail clinic services.

Weill Cornell Medicine

Weill Cornell Medicine is committed to excellence in patient care, scientific discovery and the education of future physicians in New York City and around the world. The doctors and scientists of Weill Cornell Medicine — faculty from Weill Cornell Medical College, Weill Cornell Graduate School of Medical Sciences, and Weill Cornell Physician Organization—are engaged in world-class clinical care and cutting-edge research that connect patients to the latest treatment innovations and prevention strategies. Located in the heart of the Upper East Side’s scientific corridor, Weill Cornell Medicine’s powerful network of collaborators extends to its parent university Cornell University; to Qatar, where an international campus offers a U.S. medical degree; and to programs in Tanzania, Haiti, Brazil, Austria and Turkey. Weill Cornell Medicine faculty provide comprehensive patient care at NewYork-Presbyterian/Weill Cornell Medical Center, NewYork-Presbyterian Lower Manhattan Hospital and NewYork-Presbyterian Queens. Weill Cornell Medicine is also affiliated with Houston Methodist. For more information, visit weill.cornell.edu.

Columbia University Irving Medical Center

Columbia University Irving Medical Center provides international leadership in basic, preclinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest faculty medical practices in the Northeast. For more information, visit cumc.columbia.edu or columbiadoctors.org.

Opioid crisis impacts farming communities

From the Illinois News Network:

A Morning Consult survey shows how hard the opioid epidemic is hitting farm communities across the nation, including those in Illinois.

Seventy-four percent of farmers have been directly affected by opioid abuse, the survey said. Will Rodger, director of policy communications at the American Farm Bureau Federation, which sponsored the survey along with the National Farmers Union, said the epidemic has been hitting farmers close to home.

Hospital operators in merger talks to create U.S. industry leader

From Reuters:

Ascension Health and Providence St. Joseph Health are in discussions about a merger that would create the largest hospital chain in the United States, the Wall Street Journal reported on Sunday, citing people familiar with the situation.

A deal between the two non-profits would give the combined entity 191 hospitals in 27 states and annual revenue of $44.8 billion, the paper said. That would surpass the nation’s current largest operator, HCA Healthcare Inc (HCA.N), a for-profit company.